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1.
Article in Chinese | WPRIM | ID: wpr-909256

ABSTRACT

Objective:To compare surgical methods and clinical efficacy among different types of cesarean scar pregnancy (CSP).Methods:A total of 158 patients with CSP who received treatment in Yuncheng Central Hospital from January 2016 to June 2019 were included in this study. According to Expert Consensus on Diagnosis and Treatment of Cesarean Scar Pregnancy (2016 version), type I CSP was found in 55 patients, type II in 86 patients and type III in 17 patients. These patients were divided into groups A (ultrasound-guided suction curettage), B (uterine artery chemoembolization + ultrasound-guided suction curettage) and C (laparoscopic scar pregnancy lesion resection + scar repair) according to different surgical methods. The amount of intraoperative blood loss, the difference in human chorionic gonadotropin (HCG) level between before and after surgery, the time to postoperative HCG level returning to normal level, menstruation recovery, and re-pregnancy were compared between groups.Results:The amount of intraoperative blood loss in the groups A, B and C was (43.33 ± 72.31) mL, (34.41 ± 17.16) mL, (65.71 ± 70.52) mL, respectively. There was significant difference between groups ( F = 8.51, P = 0.014]. The difference in HCG level between before and after surgery in groups A, B and C was (0.64 ± 0.18), (0.79 ± 0.10), (0.76 ± 0.19), respectively. There was significant difference in the difference in HCG level between groups ( F = 19.21, P < 0.001). There was significant difference in the incidence of postoperative menstrual volume reduction between group B and the other two groups ( χ2 = 6.73, P = 0.003). After surgery, intrauterine pregnancy occurred in 12 patients, including 8 patients in group A (type I CSP in 2 patients, type II CSP in 3 patients, type III CSP in 3 patients), 4 patients in group B (type I CSP in 3 patients, type II CSP in 1 patient). Finally, full-term fetus delivery by cesarean section was performed in 6 patients (4 patients in group A and 2 patients in group B). Conclusion:Uterine artery chemoembolization combined with uterine curettage had less blood loss, during surgery and leads to an obvious decrease in HCG level, but it can result in reduction of menstrual volume. Ultrasound-guided suction curettage is preferred for type I and type II CSP. Balloon compression can be used to stop bleeding if massive bleeding occurs. Laparoscopic scar pregnancy lesion resection plus scar repair is recommended for type III CSP.

2.
Article in Chinese | WPRIM | ID: wpr-877232

ABSTRACT

Objective@# To explore the feasibility of curettage combined with fenestration for jaw classic ameloblastoma treatment and to provide a basis for improving the treatment of classic ameloblastoma. @*Methods@# Twenty-two patients with jaw classic ameloblastoma admitted to Liuzhou People’s Hospital from 2016 to 2019 were selected. They were treated by curettage combined with fenestration. Monthly follow-up visits were conducted after surgery, and orthopantomography was performed for reexamination to observe the recovery of bone and whether there was recurrence. @*Results @#Tumors were completely scraped off in 22 patients, no pathological fracture occurred, and no wound infection occurred after surgery. After 1 to 3 years of follow-up, 19 patients showed excellent bone recovery in the original tumor area, and no recurrence was observed. Three patients relapsed and underwent a second curettage combined with fenestration, and the bone at the original tumor site recovered well. During the 12-month follow-up, no tumor recurrence was observed. After the second curettage combined with open surgery, the bone at the original tumor site recovered well. Eight patients underwent dental implants to repair dentition defects one year after surgery.@*Conclusion@#Curettage combined with fenestration is a convenient and effective treatment for jaw classic ameloblastoma.

3.
Article in Chinese | WPRIM | ID: wpr-875979

ABSTRACT

Objective@# To examine the outcome of surgical treatment in patients with stages Ⅱ-Ⅲ bisphosphonate-related osteonecrosis of the jaw. @*Methods@#Twenty-nine patients with bisphosphonate-related osteonecrosis of the jaw were examined. The patients were followed up for more than 6 months, and the treatment outcome was reviewed. @*Results@# After curettage of local lesions, 19 out of the 21 patients were cured, and 2 were relieved of symptoms. Six patients underwent subtotal resection of the maxilla, and the symptoms disappeared completely after the surgery. Two patients underwent partial resection of the mandible and recovered.@*Conclusion@#Surgical debridement is an effective measure for the treatment of patients with bisphosphonate-related osteonecrosis of the jaw in stages Ⅱ-Ⅲ. In most cases, curettage of local lesions via the intraoral approach can completely remove sequestrum and inflammatory granulomatous tissue. Subtotal maxillary resection or partial mandible resection is performed when the bone death reaches the level of the maxillary sinus floor or continues to the mandible. By timely surgical intervention, the bone lesion is removed to maintain the sterile, active bone microenvironment locally.

4.
Article in Chinese | WPRIM | ID: wpr-887499

ABSTRACT

OBJECTIVE@#To observe the clinical therapeutic effect of the combination of electroacupuncture (EA) at @*METHODS@#A total of 58 patients after uterine curettage of incomplete abortion were randomized into an EA group and a western medication group, 29 cases in each one. In the western medication group, mifepristone tablets were administered orally, 2 tablets each time, once daily. In the EA group, on the base of the treatment as the western medication group, EA was applied to @*RESULTS@#After treatment, the intrauterine residue area and CDFI blood flow signal positive rate were all reduced as compared with the values before treatment in patients of the two groups (@*CONCLUSION@#The combined treatment of electroacupuncture at


Subject(s)
Abortion, Incomplete/therapy , Abortion, Induced , Acupuncture Points , Curettage , Electroacupuncture , Female , Humans , Pregnancy
5.
Rev. chil. obstet. ginecol. (En línea) ; 85(4): 324-334, ago. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1138628

ABSTRACT

INTRODUCCIÓN Y OBJETIVOS: En Chile, existen datos parcializados en cuanto a la prevalencia de aborto. La población migrante ha generado un cambio en las características de las pacientes en situación de aborto. El objetivo es describir las características demográficas y clínicas de las mujeres con aborto de manejo quirúrgico con y sin complicaciones. MÉTODOS: Estudio Descriptivo Transversal. Se incluyeron mujeres atendidas por aborto, sometidas a método de evacuación y que estuvieran ingresadas al sistema SIP/CLAP. Se compararon mujeres con o sin complicaciones con respecto a diferentes características demográficas y clínicas. Se calculó Odd Ratio para algunas variables de interés. RESULTADOS: Se incluyeron 554 mujeres, un 13% (N= 73) tuvo complicación al ingreso, principalmente hemorrágica (40%). Las características demográficas fueron similares en ambos grupos. Hubo mayor riesgo de complicación en mujeres con abortos previos (OR: 2,4 (IC 1,3-4,5), p =0.00), cuando el diagnóstico de ingreso fue aborto incompleto (OR: 85,3 (IC 25,2-288), p=0,00) y cuando se realizó legrado (OR: 4 (IC 2,5-6,5) p=0,00). La mayoría de las pacientes con complicaciones no planeó el embarazo (OR: 11 (IC 3,4-37,7), p=0,00) y no usó método anticonceptivo en esta gestación. El 70% recibió método anticonceptivo al egreso. CONCLUSIONES: Existen características clínicas asociadas a complicación en mujeres con aborto de manejo quirúrgico en nuestro centro, como diagnóstico de ingreso, embarazo no planificado, aborto previo y tipo de evacuación. Existen limitaciones en cuanto a la cantidad y calidad de información, sin embargo, nuestros resultados permiten conocer el perfil de pacientes atendidas por aborto en nuestro centro.


INTRODUCTION AND OBJECTIVES: In Chile, there are partial data regarding the prevalence of abortion. The migrant population has generated a change in the characteristics of patients in an abortion situation. The objective is to describe the demographic and clinical characteristics of women with surgical abortion with and without complications. METHODS: Transversal Descriptive Study. Women treated for abortion, undergoing evacuation method and who were admitted to the SIP / CLAP system were included. Women with or without complications were compared with respect to different demographic and clinical characteristics. Odd Ratio was calculated for some variables of interest. RESULTS: 554 women were included, 13% (N = 73) had complication at admission, mainly hemorrhagic (40%). Demographic characteristics were similar in both groups. There was an increased risk of complication in women with previous abortions (OR: 2.4 (IC 1.3-4.5), p = 0.00), when the diagnosis of admission was incomplete abortion (OR: 85.3 (IC 25.2- 288), p = 0.00) and when curettage was performed (OR: 4 (IC 2.5-6.5) p = 0.00). The majority of patients with complications did not plan pregnancy (OR: 11 (IC 3.4-37.7), p = 0.00) and did not use a contraceptive method in this pregnancy. 70% received contraceptive method upon discharge. CONCLUSIONS: There are clinical characteristics associated with complications in women with surgical management abortion in our center, such as admission diagnosis, unplanned pregnancy, previous abortion and type of evacuation. There are limitations regarding the quantity and quality of information, however, our results allow us to know the profile of patients treated for abortion in our center.


Subject(s)
Humans , Female , Pregnancy , Adult , Young Adult , Abortion, Spontaneous/surgery , Medical Records Systems, Computerized , Curettage , Postoperative Complications , Transients and Migrants , Evacuation , Comorbidity , Abortion, Spontaneous/epidemiology , Chile , Epidemiology, Descriptive , Cross-Sectional Studies , Educational Status
6.
Gac. méd. boliv ; 43(1): 28-33, ago. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1124816

ABSTRACT

Objetivos: evaluar el uso de la dexmedetomidina intranasal como coadyuvante para sedación en LUI y AMEU asociado al sistema de infusión controlado por objetivo. Métodos: ensayo clínico no controlado, prospectivo y simple ciego. Muestra de 48 pacientes que cumplen los criterios de inclusión. Grupo CD se administró Dexmedetomidina IN a dosis de 0,9 µg/kg y otro grupo de control. Para el análisis estadístico de variables continuas se usó media y DE; para variables ordinales se calculó frecuencia. Además de prueba T de Student y Chi χ2. Nivel de confianza de 95 % y margen de error 12%. Resultados: edad media de 32 ± 7 años; en el grupo CD la dosis de inducción y mantenimiento de remifentanil fue de 2 ± 0,7 ng/ml y en el grupo SD la dosis de inducción fue de 4,1 ± 0,7 ng/ml y de mantenimiento 3,9 ± 0,5 ng/ml; para el propofol la dosis de inducción y mantenimiento fue 3,7 ± 0,5 mcg/ml en el grupo SD mientras que, en el grupo CD la dosis de inducción y mantenimiento fue de 2,1 ± 0,5 mcg/ml. La frecuencia cardiaca de 64 - 62 y en el grupo SD fue de 70 - 67 latidos/min. La PAM asociado al dexme está por 73 mmHg y el grupo de SD es de 78 mmHg. No se verifico complicaciones por la administración de la Dexmedetomidina. Conclusiones: la dexmedetomidina IN permite disminuir la dosis de los fármacos, con estabilidad de los cambios hemodinámicos, la dosis utilizada no produce complicaciones.


Objectives: to evaluate the use of intranasal dexmedetomidine as an adjunct for sedation in LUI and AMEU associated with the objective controlled infusion system. Methods: uncontrolled, prospective, single-blind clinical trial. Sample of 48 patients who meet the inclusion criteria. Group CD was administered Dexmedetomidine IN a dose of 0.9 µg / kg and another control group. For the statistical analysis of continuous variables, mean and SD were used; For ordinal variables, frequency was calculated. In addition to Student's T-test and Chi χ2. 95% confidence level and 12% margin of error. Results: age of 32 ± 7 years; in the CD group the induction and maintenance dose of remifentanil was 2 ± 0.7 ng / ml and in the SD group the induction dose was 4.1 ± 0.7 ng / ml and maintenance dose 3.9 ± 0.5 ng / ml; for propofol the induction and maintenance dose was 3.7 ± 0.5 mcg / ml in the SD group, while in the CD group the induction and maintenance dose was 2.1 ± 0.5 mcg / ml. The heart rate was 64-62 and in the SD group it was 70-67 beats / min. The MAP associated with dexme is 73 mmHg and the SD group is 78 mmHg. No complications were verified by the administration of Dexmedetomidine. Conclusions: dexmedetomidine IN allows to decrease the dose of drugs, with stability of hemodynamic changes, the dose used does not cause complications.


Subject(s)
Dexmedetomidine
7.
Article | IMSEAR | ID: sea-207852

ABSTRACT

Background: Arteriovenous malformation is abnormal connection between an organ’s arterial and venous circulation. In acquired AVM, history of uterine procedure seems inevitable. Their clinical feature is usually vaginal bleeding. It is diagnosed by 2-D ultrasonography combined with colour doppler. Most of the time they resolve spontaneously; however, if left untreated, uterine artery embolization or hysterectomy comes in hand. The purpose of this study was to evaluate the role of TVUS and colour doppler in the diagnosis and follow-up of treated cases of uterine AVM. This study also aims to evaluate different modalities to manage uterine AVM.Methods: This was a retrospective study done at tertiary care centre from January 2018 to December 2019 to assess the presentation, treatment, and clinical pictures of patients with uterine AVM that were diagnosed with TVUS. Authors reviewed both (1) clinical data (2) ultrasound data of patients. The diagnostic criteria were “subjective” with a rich vascular network in the myometrium with the use of colour Doppler images and “objective” with a high PSV of 20 cm/sec in the vascular web.Results: Thirteen patients met the diagnostic criteria mentioned above. Out of that 100% presented with on and off bleeding per vaginum. Recent and remote history of uterine procedures were in found in 84.6% (n=11) of cases. UAE was done in 53.8% (n=7) cases. Thirty-three (33%) (n=5) cases spontaneously resolved when closely monitored with serial imaging and serum beta- HCG levels. Hysterectomy was needed in 7.4% (n=1) of patients of AVM.Conclusions: Uterine AVM occurred after unsuccessful pregnancies or uterine procedures. Triage of patients for expectant treatment, hormonal treatment vs intervention with uterine artery embolization based on their clinical status, which was supplemented by objective measurements of blood velocity measurement in the AVM, appears to be a good predictor of outcome.

8.
Article | IMSEAR | ID: sea-207790

ABSTRACT

Background: Evaluation was done in 100 women presenting with postmenopausal bleeding, (PMB), to discuss the utility of hysteroscopy combined guided endometrial curettage in the diagnosis of uterine cancer and endometrial hyperplasia, and, treat benign lesions, like polyps, synechiae at the same sitting. At MGMH during the years, 2002 to 2006, there were 57 women, and at care, 40 women with PMB during 2011 to 2013, and three in a nursing home, Hyderabad, were investigated.Methods: Evaluation was done in 100 women presenting with PMB by hysteroscopy and curettage to diagnose the cause of PMB and benign lesions like polyps, synechiae were managed by operative hysteroscopy. Bettocchi 5 mm hysteroscope, monopolar instruments and glycine was used for excision of polyps.Results: In one hundred women with PMB, 19% had cancer. Endometrial adenocarcinoma in 14, endocervical carcinoma in 2, uterine carcinosarcoma in 3 cases. All 3 cases of uterine carcinosarcoma on hysteroscopy were large polyps measuring 5×5-6 cm size. Atypical hyperplasia endometrium in 7% and simple hyperplasia in 17%, was reported on histopathology, in cases with hyperplastic endometrium on hysteroscopy. Benign polyps in 41% were managed at the same sitting by operative hysteroscopy.Conclusions: Women with postmenopausal bleeding must have USG, trans vaginal sonography (TVS), endometrial thickness (ET) measurement, preferably endometrial echo complex (EEC). In women with PMB, the risk of uterine cancer would be 19%, i.e., 1 out of 5 women. Atypical hyperplasia in 7%. Hysteroscopy guided curettage, with histopathology, is the gold standard protocol in cases of PMB.

9.
Article | IMSEAR | ID: sea-207720

ABSTRACT

Entero-uterine fistula is a very rare type of fistula between the small intestine and the genital tract. They may result from obstetric or gynaecological procedures like post D and C perforation of the uterus. Timely detection and management reduce morbidity and mortality of the patients. We present a case of entero uterine fistula in a lady which was diagnosed on second postnatal day when she complained of passage of stool per vaginum. She had a previous history of mid trimester abortion followed by D and C after which she remained hospitalised for a week for pain abdomen. The diagnosis of this fistula was based on her symptoms and clinical evaluation of passage of intestinal content through the cervix and CT scan finding of gas in the abdomen. Intraoperatively an ileal loop was found adherent to the posterior wall of uterus with large fistula between bowel and the uterus. There was no intraperitoneal faecal contamination. Adherent small bowel was separated from the posterior wall of the uterus and fistula dismantled. Side to side functional end to end anastomosis was done using TLC 75 stapler. Repair of the uterine rent was also done. Post op recovery was uneventful.

10.
Article | IMSEAR | ID: sea-207673

ABSTRACT

Background: The objectives of the study was to establish the role of histopathological diagnosis of uterine endometrial lesions in patients of AUB at perimenopausal age and to correlate the transvaginal sonographic (TVS) finding with histopathological examination.Methods: This prospective observational study was carried out over 1 and 1/2 years in the two apex level teaching hospitals in eastern India. A total of 197 women in the age group of 40-49 years and ≥50 years (up to 55 years) who presented with abnormal uterine bleeding were included in the study. After selecting the patient with eligibility criteria in the OPD, detailed clinical history, systemic and gynecological examinations and investigations were done as per proforma. TVS study of endometrial pattern and thickness was measured followed by dilatation and curettage (D and C) and HPE of the endometrial curetting was done.Results: Menorrhagia (44.67%) was the most common clinical finding. Mean endometrial thickness measured by TVS was 7.04±2.11 mm in proliferative phase and 10.25±1.27 mm in the secretory phase. Proliferative endometrium (37.06%) was the most frequent finding in HPE followed by secretory endometrium (20.3%). Hyperplasia of endometrium was noted in 27 cases (100%) at 12-15 mm of endometrial thickness on TVS whereas endometrial hyperplasia with and without atypia and endometrial carcinoma was noted in 25 cases (92.59%) at the same thickness of 12-15 mm of uterine endometrium on HPE. Endometrial hyperplasia and polyp both had sensitivity of 84.21% and 71.43% respectively on TVS as compared with histopathology.Conclusions: Increased endometrial thickness and echo pattern by TVS correlated well with abnormal endometrial tissue histopathology in perimenopausal women with AUB.

11.
Article | IMSEAR | ID: sea-207672

ABSTRACT

Background: Abnormal uterine bleeding is defined as any type of bleeding in which the duration, frequency or amount is excessive for an individual patient. Hysteroscopy has ushered a new era in the evaluation of abnormal uterine bleeding. With this background, we conducted a study to find the role of hysteroscopy with dilation and curettage in post-menopausal bleeding.Methods: It was an observational study conducted in the department of obstetrics and gynecology of a tertiary care hospital in Maharashtra. Post-menopausal patients with abnormal uterine bleeding, admitted in the period of March 2018 to September 2019 were included in the study. A pretested and predesigned questionnaire was used to collect the data. Hysteroscopy with dilation and curettage was done and samples were sent for histopathology.Results: Bleeding was present in all the 30 cases. About 33.33% had pain abdomen, 56.67% had hot flushes, 10.00% had mass and 10% had other symptoms in the present study. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of hysteroscopy in diagnosing malignancy was 75%, 96.15%, 75%, 96.15% and 93.33% respectively.Conclusions: To conclude the most common cause of abnormal uterine bleeding in post-menopausal women in our study was polyp. The sensitivity and specificity of the hysteroscopy in diagnosing the malignant lesions is 75% and 96.15% respectively which corroborated with other study findings. Hysteroscopy with dilation and curettage is better alternative to hysterectomy and biopsy in most of the cases.

12.
Article | IMSEAR | ID: sea-207569

ABSTRACT

Background: Under normal circumstances, a woman's uterus sheds a limited amount of blood during each menstrual period (around 80 ml). Bleeding that occurs erratically or excessive menstrual bleeding is called abnormal uterine bleeding (AUB). The causes of AUB are many and varied. Initial investigations include transvaginal ultrasound and histopathologic assessment of the endometrium. Objective of this study was to evaluation of endometrial thickness with trans-vaginal ultrasound and its correlation with histopathology by dilatation and curettage in abnormal uterine bleeding. To determine the efficacy of transvaginal ultrasound in evaluating the endometrial thickness. To correlate the endometrial thickness by transvaginal ultrasound with endometrial histopathology in women with AUB.Methods: It is a retrospective observational study. All reproductive and perimenopausal age group women who underwent dilatation and curettage for abnormal uterine bleeding during the period June 2014-June 2016 was taken and analyzed and correlated with their endometrial thickness measured with Transvaginal ultrasound.Results: Around 478 patients who underwent endometrial sampling over a period of two years were analyzed. Maximum number of patients were in the fourth decade and the overweight category 36.6%. Proliferative endometrium was the most common histopathologic picture (44.76%). Detection of precancerous lesions were-5.87% and endometrial cancer was 1.05%.Conclusions: An ET of 8 mm and above gave 100% sensitivity and negative predictive value for precancerous and cancerous lesions.

13.
Article | IMSEAR | ID: sea-207530

ABSTRACT

Background: morbidly adherent placenta has an increasing incidence over decades. The purpose of this study is to identify risk factors and etiology of placenta previa- accreta and percreta.Methods: A cross sectional observational study of patients with morbidly adherent placenta previa including placenta accreta and placenta percreta were studied over a period of three years from June 2017 to June 2019 in a tertiary care centre, Mumbai.Results: Cases showed a higher incidence in patients with previous cesarean delivery (CS), grandmultiparity, abortions without the history of check curettage and anterior/central placentae.Conclusions: History of uterine surgeries and previous cesarean are some important risk factors for accreta in placenta previa patients.

14.
Article | IMSEAR | ID: sea-207526

ABSTRACT

Background: Patient satisfaction after a surgical procedure is an important outcome of hospital care. Many of the gynaecological menstrual problems such as abnormal uterine bleeding, postmenopausal bleeding requires endometrial evaluation which is done traditionally by dilatation and curettage. But this procedure is painful and requires appropriate pain management protocol. The aim is to evaluate the post-operative patient satisfaction following dilatation and curettage procedure.Methods: This study was conducted in a tertiary care hospital belonging to a medical college. A total of 236 patients were recruited for the study who subsequently underwent dilatation and curettage with different mode of Xylocaine anesthesia for pain relief. Of them 16 patients were excluded due to valid reasons and the remaining 220 were interviewed face to face following the procedure. The level of anxiety was assessed using Beck’s Anxiety inventory and also perception of satisfaction was documented along with complication related to the anesthesia.Results: The overall level of satisfaction was higher in the group receiving both paracervical block and intrauterine instillation of lidocaine during the procedure of dilatation and curettage. A further analysis showed that increase in level of satisfaction was due to improvement in pain scores due to combined mode of paracervical and endometrial anesthesia.Conclusions: A multimodal pain management protocol which involves pre-procedural sedation, combined cervical and endometrial anesthesia improves overall outcome with respect to reduction in anxiety scores and postoperative satisfaction levels.

15.
Braz. j. otorhinolaryngol. (Impr.) ; 86(1): 38-43, Jan.-Feb. 2020. tab
Article in English | LILACS | ID: biblio-1089367

ABSTRACT

Abstract Introduction Adenoidectomy can be performed with many ways, including curettage and microdebrider endoscopic-assisted adenoidectomy. Those two techniques have advantages and disadvantages. Objective The objective of this study is to research the effects of curettage adenoidectomy and endoscopic-assisted microdebrider adenoidectomy on the tympanum pressures in pediatric patients with adenoid hypertrophy without otitis media with effusion. Methods This prospective descriptive study was performed with 65 patients who had a normal tympanic membrane and normal tympanogram and then underwent adenoidectomy or adenotonsillectomy for adenoid and tonsil hypertrophy. The subjects were randomly divided into two groups: curettage adenoidectomy group and endoscopic microdebrider-assisted adenoidectomy group. They underwent tympanometry, and the preoperative as well as 1st and 7th day postoperative values of the tympanum pressures were compared within and among the groups. Results There were 32 patients in the curettage adenoidectomy group and 33 patients in the microdebrider adenoidectomy group. Statistically significant differences were observed in the median tympanum pressure on the preoperative and 1st and 7th postoperative days for both the left and right ears with curettage adenoidectomy (p < 0.001, p < 0.001). This difference occurred on the 1st postoperative day, and the value returned to normal on the 7th day. There was no significant difference in the median tympanum pressure on the preoperative and 1st and 7th postoperative days for both the left and right ears in the microdebrider adenoidectomy group (p = 0.376, p = 0.128). Conclusion Postoperative Eustachian tube dysfunction is seen less often with the endoscopic-assisted microdebrider adenoidectomy technique than with the conventional adenoidectomy technique.


Resumo Introdução A adenoidectomia pode ser realizada de várias maneiras, inclusive por curetagem e por microdebridador, assistida por endoscopia. Essas duas técnicas têm algumas vantagens e desvantagens. Objetivo O objetivo deste estudo foi investigar os efeitos da técnica de adenoidectomia por curetagem e da adenoidectomia por microdebridador assistida por endoscopia sobre a pressão timpânica em pacientes pediátricos com hipertrofia adenoideana sem otite média com efusão. Método Estudo descritivo prospectivo feito com 65 pacientes que apresentavam membrana timpânica e timpanograma normais, que foram então submetidos à adenoidectomia ou adenotonsilectomia por hipertrofia adenoamigdaliana. Os pacientes foram divididos aleatoriamente em dois grupos: grupo adenoidectomia por curetagem e grupo adenoidectomia por microdebridador assistida por endoscópio. Todos os pacientes fizeram timpanometria e os valores das pressões do tímpano pré-operatórios e pós-operatórios no 1º e 7º dias foram comparados intragrupos e entre os grupos. Resultados Foram incluídos 32 pacientes no grupo adenoidectomia por curetagem e 33 pacientes no grupo adenoidectomia com microdebridador. Diferenças estatisticamente significantes foram observadas na mediana da diferença entre a pressão timpânica no pré-operatório e no 1º e 7º dias de pós-operatório para ambas as orelhas, direita e esquerda, na adenoidectomia por curetagem (p < 0,001, p < 0,001). Essa diferença ocorreu no 1º dia do pós-operatório e o valor retornou ao normal no 7º dia. Não houve diferença significante na mediana entre pressão timpânica no pré-operatório e no 1º e 7º dias de pós-operatório para as orelhas direita e esquerda no grupo de adenoidectomia com microdebridador (p = 0,376, p = 0,128). Conclusão A disfunção tubária no pós-operatório é observada menos frequentemente com a técnica de adenoidectomia por microdebridador assistida por endoscopia quando comparada com a técnica convencional.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adenoidectomy/methods , Curettage/methods , Eustachian Tube/physiopathology , Postoperative Period , Pressure , Acoustic Impedance Tests , Single-Blind Method , Prospective Studies , Treatment Outcome , Video-Assisted Surgery/methods , Debridement/methods , Ear, Middle/physiopathology
16.
Article | IMSEAR | ID: sea-207404

ABSTRACT

Background: Worldwide Infertility rate prevails around 8-12% of all couples; approximately 80 million are infertile. In India 10-15% of couples are infertile. Investigating for infertility is to intervene into the modifiable/treatable causes. Therefore, the present study has been undertaken to investigate the morphological patterns of endometrial tissue in women with primary infertility.Methods: The study included 60 cases with complaints of infertility (primary). The premenstrual D and C was done to obtain endometrial biopsy. The present prospective study was a descriptive study and the values are mentioned in percentages.Results: In present study a total of 60 cases were studied. Out of which 36 cases (60%) belonged to the young adult age group. The predominant morphological pattern was that of secretory endometrium seen in 22 cases (36.66%) as opposed to proliferative, endometritic or tubercular pattern. The predominant menstrual pattern recorded was regular; seen in 41 cases (68.33%) as opposed to irregular or mennorhagic patterns.Conclusions: The endometrial biopsy has a great role in screening the cases of infertility as it helps to assess the information about ovulation, ripening of the endometrial tissue and other abnormal endometrial reaction, hormonal imbalance. This is the only method to label the diagnosis of endometrial tuberculosis in an apparently healthy female.

17.
Article | IMSEAR | ID: sea-211002

ABSTRACT

The study was done to compare the diagnostic efficacy of endometrial biopsy obtained by Karman suctioncannula with conventional D&C following TVS in patients with AUB. 100 patients of AUB presenting ingynaecology OPD were studied with history, examination, laboratory investigations, TVS, endometrial aspirationusing Karman cannula and endometrial curettage. It is concluded that endometrial aspiration is an effective,useful and minimally invasive procedure and can be used for the primary investigation of women with AUBalong with TVS.

18.
Article in Chinese | WPRIM | ID: wpr-799087

ABSTRACT

Objective@#To assess the clinical value of uterine curettage ultrasound in the evaluation of cesarean section scar pregnancy (CSP) after uterine arterial chemoembolization (UAE).@*Methods@#Retrospective analysis were performed in 42 patients who took uterine curettage within 24-48 hours after UAE treatment in the Second Affiliated Hospital of Harbin Medical University from January 2015 to June 2018. The ultrasonic manifestations were graded and classified before UAE. The intraoperative and postoperative complications, time of β-human chorionic gonadotrophin declined to normal limits were evaluated, and the formation of hematoma and hematoma absorption time were followed up by ultrasound.@*Results@#UAE was performed successfully in all patients. The ultrasound-guided scar pregnancy was successfully completed. The uterus was successfully retained in all patients.Among the 42 patients, 18 cases were 3 scores group, and 24 cases were 4 scores group according to the ultrasonic scoring system. Two cases were type Ⅰgroup, 25 cases were type Ⅱ group, and 15 cases were type Ⅲ group according to the ultrasonic classification. The amount of intraoperative complications, postoperative mass formation and absorption time were significantly different between 3 scores group and 4 scores group (P<0.05). No significant differences were found in intraoperative complications, postoperative complications, postoperative mass formation and β-human chorionic gonadotropin (β-hCG) value among different ultrasonic classification groups (P>0.05).@*Conclusions@#Ultrasonography has clinical application value in evaluating the prognosis of CSP treated with UAE. Ultrasonic scoring system can evaluate the efficacy and is helpful for predicting clinical outcome of CSP.

19.
Article in Chinese | WPRIM | ID: wpr-798965

ABSTRACT

Objective@#To compare clinical efficacy and safety of microwave therapy versus suction-curettage through small incisions in the treatment of axillary osmidrosis.@*Methods@#Totally, 60 patients with axillary osmidrosis were enrolled from Department of Dermatology, Xijing Hospital, Fourth Military Medical University from January 2017 to February 2018. Every patient received miraDry microwave therapy on the left axillary (microwave therapy group) and suction-curettage through small incisions on the right axillary (suction-curettage group) , and operation duration was recorded. After follow-up of half a year, clinical efficacy and complications were compared between the two groups.@*Results@#After 6-month follow-up, no significant differences were observed in the response rate or recurrence rate between the microwave therapy group (93.33%[56/60], 6.67%[4/60] respectively) and suction-curettage group (96.67% [58/60], 3.33% [2/60] respectively; both P > 0.05) . However, the incidence rate of postoperative complications was significantly lower in the microwave therapy group (0) than in the suction-curettage group (6.67% [4/60], χ2 = 4.138, P = 0.042) .@*Conclusion@#Compared with suction-curettage through small incisions, microwave therapy has advantages of being non-invasive and less postoperative complications.

20.
Article in Chinese | WPRIM | ID: wpr-870219

ABSTRACT

Objective To compare clinical efficacy and safety of microwave therapy versus suction -curettage through small incisions in the treatment of axillary osmidrosis.Methods Totally,60 patients with axillary osmidrosis were enrolled from Department of Dermatology,Xijing Hospital,Fourth Military Medical University from January 2017 to February 2018.Every patient received miraDry microwave therapy on the left axillary (microwave therapy group) and suction-curettage through small incisions on the right axillary (suction-curettage group),and operation duration was recorded.After follow-up of half a year,clinical efficacy and complications were compared between the two groups.Results After 6-month follow-up,no significant differences were observed in the response rate or recurrence rate between the microwave therapy group (93.33%[56/60],6.67%[4/60] respectively) and suction-curettage group (96.67% [58/60],3.33% [2/60] respectively;both P > 0.05).However,the incidence rate of postoperative complications was significantly lower in the microwave therapy group (0) than in the suction-curettage group (6.67% [4/60],x2 =4.138,P =0.042).Conclusion Compared with suction-curettage through small incisions,microwave therapy has advantages of being non-invasive and less postoperative complications.

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